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What This Guide Helps With
Checkout fails because of cassette seating, breathing-system leaks, damaged accessories, moisture, obstruction, or flow-sensor problems.
Step-by-Step Troubleshooting
1. Protect the Patient and Remove the Machine From Clinical Dependence
Do not continue using a Flow-e that cannot pass required ventilator, leak, or flow-sensor checkout testing. If the machine is assigned to an active case, transition the patient to a verified alternative anesthesia system before troubleshooting.
Record exactly which checkout step fails.
Expected outcome: Patient support is maintained elsewhere, and the failed checkout test is clearly identified.
2. Repeat the Test Under Controlled Conditions
Repeat the applicable checkout once, making sure the machine is configured exactly as required for the test and no one is manipulating the breathing circuit during the procedure.
Do not repeatedly bypass or ignore a failed checkout.
Expected outcome: The failure is reproducible. If the repeat test passes and inspection reveals no intermittent condition, complete the full checkout before considering the issue resolved.
3. Inspect the Patient Cassette Installation
Confirm the patient cassette is fully inserted, correctly positioned, latched as intended, and free of visible cracks, contamination, fluid, or damaged accessible seals.
Remove and reinstall the cassette if permitted by normal operator-accessible procedures.
Expected outcome: The cassette seats completely and is recognized normally. If reseating restores successful checkout, troubleshooting can stop after the full checkout passes.
4. Inspect the Entire External Breathing Circuit
Check inspiratory and expiratory limbs, Y-piece, filters, reservoir bag, test lung, connectors, and other installed accessories for loose connections, open ports, tears, cracks, obstruction, or incorrect assembly.
Temporarily simplify the circuit to the manufacturer-approved checkout configuration where appropriate.
Expected outcome: The external breathing circuit is complete, correctly assembled, unobstructed, and leak-free. Correct any defect and repeat checkout.
5. Check Accessible Seals and Connections
Inspect cassette interfaces and other externally accessible breathing-system seals for debris, deformation, moisture, or improper seating.
Do not disassemble internal pneumatic assemblies.
Expected outcome: Accessible sealing surfaces are clean and intact. If correcting an external sealing issue allows the leak test to pass, troubleshooting can stop after final verification.
6. Inspect Flow-Sensing Components
Verify accessible flow sensors and associated connectors are correctly installed, clean as permitted by approved procedures, dry, and free from visible damage or contamination.
If an approved known-good compatible sensor is available, substitute it.
Expected outcome: The sensor is recognized and calibration completes successfully. If a known-good sensor resolves the failure, remove the suspect sensor from use and complete full checkout.
7. Check for Moisture or Condensation
Look for condensation or fluid in accessible breathing-system components, sensor interfaces, sampling components, and circuit tubing.
Moisture can affect flow measurement and sealing.
Expected outcome: Components used for checkout are dry and properly assembled. After correcting moisture-related external problems, calibration and leak testing pass normally.
8. Perform Controlled Leak and Ventilation Verification
Using an approved test lung and anesthesia test equipment, repeat the manufacturer-approved leak, ventilator, and flow-sensor checks.
Observe whether the failure remains tied to one cassette, one sensor, or one external circuit component.
Expected outcome: All applicable checkout stages pass. If they do, complete final functional verification before return to service.
9. Substitute Known-Good External Components
When available, compare with known-good compatible breathing components, cassette, or approved flow sensor one item at a time.
Avoid changing several components simultaneously because doing so obscures the actual cause.
Expected outcome: A faulty external component can be isolated. Replace or remove that component from service and confirm checkout passes.
10. Escalate an Unresolved Checkout Failure
If the Flow-e continues to fail required leak, ventilator, or flow-sensor testing after external components have been ruled out, stop troubleshooting.
Expected outcome: The machine remains removed from service for qualified bench evaluation.
If the Problem Persists
External circuit assembly, cassette seating, accessible seals, moisture, and replaceable flow-sensing components have been checked. Remaining causes may involve internal pneumatic valves, internal leak paths, pressure or flow measurement components, calibration, internal connections, or service-level configuration.
The device should be:
- Removed from service.
- Labeled Out of Service.
- Sent for repair or bench evaluation.
- Evaluated using appropriate Getinge service documentation and approved anesthesia test equipment.
- Repaired or calibrated only by qualified personnel.
Do not return an anesthesia machine to clinical use when required checkout cannot be completed successfully. Knowing when to stop after external causes are eliminated is proper troubleshooting.
Return-to-service testing should include full checkout, ventilation verification, leak testing, flow verification, alarm testing, and applicable electrical-safety testing.
Clinical Use Tip
A failed leak or ventilator checkout is a stop-use condition until the Flow-e passes the required functional verification.
Work Order Documentation (CCR Method)
CCR = Complaint, Cause, Resolution
Complaint
What was reported by the clinical staff.
Example:
"Anesthesia staff reported that the Flow-e repeatedly failed the patient cassette leak test during morning checkout."
Cause
What was observed during troubleshooting.
Example:
"Clinical Engineering found an incompletely seated breathing-circuit connection at the patient cassette."
Resolution
What action was taken.
Example:
"Reseated the connection, repeated the complete checkout, and verified successful leak, ventilation, and flow-sensor testing before return to service."
Helpful Details to Include (If Known)
- Exact checkout stage that failed
- Patient cassette condition
- Circuit configuration
- Visible leaks or loose connections
- Flow-sensor condition
- Moisture or contamination observed
- Known-good substitutions
- Results before and after correction
- Full checkout result
- Final device status
Final Thought
Begin with patient safety, reproduce the checkout failure, inspect the entire external breathing path before suspecting internal pneumatics, verify the correction with complete checkout testing, and document exactly what was found.
That is successful troubleshooting.